NPIMap

Organization Active NPI

Neurologic Wellness Institute PLLC

  • Neurology Chiropractor
  • Boca Raton, FL
National Provider Identifier
1154073302
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
Legal business name
NEUROLOGIC WELLNESS INSTITUTE PLLC
Practice address
7700 Camino Real Ste 320
Boca Raton, FL 33433-5576
Phone
(908) 418-0721
NPI assigned
Jan 19, 2022
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kelsey Brenner, DC, DACNB
Title
Owner
Phone
(908) 418-0721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN0400X Primary

Addresses

Primary practice location

7700 Camino Real Ste 320
Boca Raton, FL 33433-5576

Mailing address

7623 NW 122ND Dr
Parkland, FL 33076-4542
Phone (908) 418-0721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220408001543 FL Part B Supplier - Clinic/Group Practice 4486040938 Receives reassigned benefits from 3 practitioners
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

7700 Camino Real
Ste 320
Boca Raton, FL 33433
Phone (630) 766-1522

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1154073302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7623 NW 122ND DR",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330764542",
            "telephone_number": "908-418-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 CAMINO REAL STE 320",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335576",
            "telephone_number": "908-418-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGIC WELLNESS INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-418-0721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, DACNB"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.